Rapid InterventionTechniques

Article
Oct 31, 1997

Some of the most important steps that can be taken to prepare a members of rapid intervention team (RIT) for the tasks they may have to perform are to establish standardized tool assignments and practice common removal techniques. While the vast array of possible scenarios that can be encountered preclude knowing every possible tool or technique that will be utilized, the basic items can be determined from past events, ways that others have gotten themselves in trouble and the ways that got them out.

RIT Tools

The rapid intervention team must report on the scene ready to go to work with the tools that are likely to be required. Think of the first group as tools that every member stepping off the rig should have in his or her possession at all times. They include:

Power saw, either wood- or metal-cutting, depending on the size-up of the building

Suitable ladders for the building involved tower, aerial or portable.

In addition, at the scene the unit should attempt to obtain, if available, a copy of the building's floor plan ("You Are Here" signs) and a copy of the command chart that indicates which units are operating and where they are located. Also, if possible, locate a hoseline that can be committed for rapid intervention in the event it is needed. Know what unit is supplying the line.

RIT Size-Up

As with every other fireground task, the RIT must perform a size-up. The specific duties of the RIT make its size-up somewhat unique. While encompassing all aspects of the standard 13-point approach and the Firefighter Survival Survey, the RIT's size-up takes extra considerations. The RIT officer should:

Request size-up of the building by radio while still en route. Size of building, construction, occupancy and fire location.

Monitor tactical and command channels for urgent or Mayday messages.

Once at the scene, perform the RIT size-up (building, occupancy, fire location and extent).

Location of units/members and their access-egress.

Progress of operations.

When firefighters are trapped or missing, the RIT must have prepared for the occasion with some techniques which have been practiced and honed so they can be performed blindfolded, because that's exactly the way they're going to have to be done. The fireground is extremely confusing when a Mayday has occurred. Of course, no two situations are exactly alike but some problems repeat themselves so often that we should expect them to occur and have a game plan all worked out in advance for when they do.

Firefighter Removals

As soon as the first report is received of a "firefighter down," three things should immediately happen. First, if not already at the scene, an advanced life support (ALS) ambulance should be called. Second, additional firefighting personnel must be special called; this may require transmission of multiple alarms or calls for mutual aid. Third, a protective hoseline, a spare mask and a resuscitator should be brought to the vicinity of the member, even if there is no obvious immediate need for them.

Photo by John NormanThe rapid intervention company must report in with all necessary tools, ready to go to work.

These incidents have a tendency to go from bad to worse. What may look at first glance like a simple removal can often disintegrate into a nightmare of failed efforts. Firefighter rescue is a lot different from the rescue of most civilians. For one thing, all firefighters are full grown adults (some of us are more "full grown" than others); there are no 55-pound children being thrown over one arm here. Second is the complications of the turnout clothing and SCBA, which add weight and get hung up on obstacles. Finally there is the psychological stress of knowing this is "one of our own" who will die if we don't get him or her.

If resources and fire conditions permit, multiple avenues of approach should be begun simultaneously. Whichever team gets the victims to safety first will have proven to be effective but if the first attempt fails, a backup plan will already be under way. At most incidents where a firefighter is trapped, the best resource you can have is additional firefighters. Much of the work, including transporting victims, debris removal, etc., will have to be done by hand. A clear chain of command is critical in these instances, though, with a single person designated as the victim-removal officer making decisions as to what steps will be taken and in what order.

Depending on the fire conditions and the mechanism of injury, various drags or carries may be appropriate. Since a large percentage of firefighters in trouble involve those who have run out of air or are otherwise overcome, most often our priority is to remove the victim to a tenable atmosphere with little danger from spinal injury. Under these circumstances, horizontal movement is possible by a single member under many conditions. Grasping the turnout coat collar behind the neck or a combination of coat collar and SCBA straps, will allow a headfirst drag, the preferred position if at all possible. Dragging head first protects the head from getting caught on most obstacles and also prevents the arms and legs from getting wedged into obstructions.

If two rescuers are available and space permits, they should work side-by-side, at the victim's head. It is not practical to try to push dead weight. If one rescuer works at the head and the other at the legs, the member at the head ends up doing 75 percent of the work, and the member at the legs only about 25 percent. If this is the only possible way because of space considerations, the stronger member should be at the head (or the member with the most remaining air supply). Be prepared to switch positions as one member becomes fatigued. If conditions permit, a cadence count i.e., "one, two, three, pull..." helps to coordinate this effort.

If the victim must be brought downstairs before reaching a place of safety, the technique used will vary with the resources available and the weight of the victim. A light- to moderate-weight victim can be brought down by one person using the same drag used to reach the stairs (use extra care to protect the head and neck). A very large firefighter victim in turnout gear and SCBA can be a very difficult challenge to move down a tight staircase. In this case two firefighters and one length of rope can readily solve the problem. Again, using the drag that was used to reach the stairs, one firefighter starts down the stairs with the victim's head and shoulders, shielding this area from harm. At the same time, the second firefighter, rather than trying to carry the lower body and risking being pulled down the stairs on top of both the victim and the first rescuer, simply ties either the handcuff knot or a clove hitch and binder around both the victim's legs at the ankles. This rescuer can the control the victim's descent by feeding rope hand over hand from the landing. Since gravity is assisting the first rescuer, even a small-framed person should be able to move a large victim once on the stairs. The rescuer at the top can provide braking action to control the rate of descent either by taking a half turn around an object or by laying the rope under his foot and flat along the landing, making the rope bend over the lip of the top stair.

Photo by Paul HashagenRapid intervention crews must practice techniques for removing unconscious firefighters out windows, up and down stairs, and up through holes in floors.

It is important to note that this technique is a "fast and dirty" method of improvising a rope-lowering system using the barest of essentials; the 40-foot personal rope is more than sufficient. The rope will not be carrying the person's full live load, the staircase will! It is designed to allow a rapid removal of single, large bodyweights when conditions are life threatening. This is not the time or the place for fancy mechanical advantage systems which are probably out on the apparatus. This method can readily be put in place in a matter of 30-40 seconds using material which should be readily available on the person of any firefighter who ever contemplates going above a fire for search or rescue.

The removal of a heavy firefighter out of a window and onto a ladder is a serious challenge. If the window sill is high or the working room is constricted, firefighters on the inside will have severe difficulty in removal. One of the first steps to try is to get a member underneath the victim, by rolling the unconscious member onto the crouched rescuer's back. The rescuer then can use his powerful leg and back muscles, not merely his arms, to push the victim up to window sill height. A second rescuer inside can assist in keeping the victim in place on the first rescuer's back, and in passing him or her out to another rescuer on a ladder. When possible, the ladder removal can be made safer and smoother by placing two or even three ladders side by side with a rescuer and backup (this could be a civilian) on each.

If conditions prohibit the rescuer from getting under the victim, and the victim cannot be lifted to the sill by the members inside, then we have to arrange for the members outside to help. This requires the use of a rope and a high-point anchor. The rope must be secured around the victim and then passed up, out of the window, over a rung of the ladder, down along the inside of the ladder and then out along the ground, long enough to allow three or four rescuers to grab the rope and pull. The rescuers inside assist the victim up to window sill height, while the members outside perform most of the lifting effort. The rescue knot is passed up the ladder, over an upper rung and into the inside members who secure the victim. The signal to haul is then given to the rescuers below.

Removing a victim up a stair is another severe challenge, usually seen in below-grade situations, cellar fires and the like. An approach that may work well under these conditions involves the use of a rope and a backboard. The member is dragged to the base of the staircase, where a backboard is laid along the stair. The victim is secured at the wrists or ankles with a clove hitch and binder on one end of the rope. The rope is run up to the surface where it is grasped by two to four rescuers and the free end of the same rope is run back down the stairs, where it is tied to the top of the backboard.

Once the victim is secured to the rope, the signal to haul is given, pulling the victim feet first onto the backboard. One rescuer stabilizes the head and neck and maintains an open airway. Once the victim is fully onto the backboard, both ends of the rope are pulled by the surface rescuers, bringing the victim and the board up simultaneously. The use of the board is very important it prevents the victim from getting caught on stair treads as the ascent is made. The operation can be made easier if a ladder can be placed on the stairs for the board to slide on.

The third situation in which we find severe difficulties in removing an unconscious firefighter is the firefighter who has fallen into an opening in a floor or roof to a lower floor. While as many routes to the victim as possible should be attempted, the most direct route is often through the same opening into which the victim has plunged. This could mean lowering a ladder through the opening if space permits, or it could require a member to be lowered or rappelled via rope to the victim.

Once rescuers have reached the victim, the most appropriate available removal route should be taken: up or down stairs, out a window, etc. In some cases, though, the only available removal route will be back up through the hole the member fell into. Since a fall is involved, spinal injury is a major concern. If it is at all possible, the member should be secured in a spinal immobilization device.

A "last ditch" method that requires only the personal rope may be the only thing that works. This method involves lowering the middle of the rope down through the hole, where a slip-on "handcuff" knot is placed around the victim's wrists or ankles. If time permits, lower a second personal rope and place another handcuff knot right along side the first one, on the same wrists or ankles. Once the victim is secured, the signal to haul is given and two or more rescuers on each end of each rope begin to hoist. This allows four rescuers to hoist vertically, which is the minimum that should be used.

This method has several advantages to recommend it when severe conditions demand. By hoisting on the extremities, the arms are always extended overhead, reducing the body's profile at the shoulder area, which is the widest part of a body if the arms are down. The knot is exceptionally easy to apply. It can be tied and placed in under 30 seconds. Placing the knot around the victim's ankles and hoisting head down serves to anatomically align the spine, with the head placing "traction" on the spine with its own weight. This also ensures an open airway for the victim. If conditions permit, a backboard should be placed at the mouth of the opening, so that the member is hauled up, sliding onto the board. Then the member may be strapped on and safely transported from the area.

Two factors that repeatedly have shown themselves to be a problem are lack of planning for the emergency and allowing a "panic" mode to set in because it is a firefighter who is trapped. Training and drills in trapped firefighter removal help to deal with each of these problems.

John Norman, a Firehouse® contributing editor, is a captain with the FDNY, assigned to Rescue Company 1 in Manhattan. He is also an instructor at the Nassau County, NY, Fire Service Academy and lectures nationally on fire and rescue topics. Norman is the author of Fire Officer's Handbook of Tactics, which may be ordered by calling 800-752-9768.